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The John Radcliffe Hospital in Oxford is acknowledged to be a leading centre in the UK for medical excellence. Named after John Radcliffe, an 18th century physician, it is the main teaching hospital for Oxford University. The Maternity Unit at the hospital delivers more than 6000 women annually. More than 500 of these are problem pregnancies that are looked after in the Silver Star Unit, which is one of the longest established High Risk Maternity Units in the UK.

The Silver Star Unit is renowned for its unique approach to looking after problem births. It frequently leads the medical fraternity in new methods of care, which have been adopted in hospitals across the UK as best practice. The unit has now embarked on another project of best practice. It has digitised its specialist patient records from the past 20 years. This is helping them to keep patient information safe, and allows easy and quick access to critical data when time is of the essence.

PRESCRIBING DOCUMENT MANAGEMENT
Complicated cases lead to complicated records. The heart of Silver Star record keeping is a summary document, the Flow-Chart, where the essentials of the care of a woman, sometimes over many months, are summarised in an 'at a glance' format. Many women return for further pregnancies in which case the previous Flow-Charts give fast access to the details of their previous pregnancies.

Professor Chris Redman, lead doctor at the Silver Star Unit for over 35 years explains, "During pregnancy, doctors and midwives need patient information instantly to deliver the best care. Paper records are bulky, slow to access and are often lost or damaged. Moreover there is only one available per patient so that all members of a multidisciplinary team may not have equivalent access to vital details."

Professor Redman continues "When I started my work at John Radcliffe Hospital back in the 1970s we were working with what were considered state of the art systems. Well, medicine has moved on since then and yet our record systems have not developed. With my retirement a little over a year away, we wanted to get our paper archives digitised before I leave."

CATALYST FOR CHANGE
The unit looked for a company to supply a system that could safely store two decades of patient data safely in a form where it could be retrieved for clinical care, audit or research. The Professor turned to long time supporter of the Silver Star Unit and Technology Solutions Provider, Flamble Ltd. to develop a bespoke system. David Sherwood, Managing Director of Flamble Ltd. explains the challenges that a solution like this poses:

"The major problem with digitising the Unit's Flow-Charts has been the page size. We were used to dealing with A4, but the Flow-Charts are all A3! Worse, the pages can be double A3 with two pieces of paper being stuck together. This raised many problems. We had to deal with issues like offsetting, where the paper isn't exactly aligned. We needed a scanning system that could deal with this size of paper and could also scan duplex to get all the critical information in one scan."

WHAT THE DOCTOR ORDERED
To get the job done Flamble and the Silver Star Unit looked to Fujitsu and their fi-5750C scanner. The Fujitsu fi-5750C is a 200 sheet ADF-powered device that can cope with mixed quality sheets from A8 up to the A3 size used by the Silver Star Unit. The scanner also has a flatbed function for scanning delicate documents which is ideal for older medical charts that are prone to damage.

"The reason we settled on this scanner is that it offered the double A3 length scanning that we needed," continues David Sherwood. "We compared it with other scanners available in the same price range, and it was the only scanner that could tolerate two sheets of A3 which have been taped together, sometimes offset by as much as 1cm. When the staff at the hospital stuck the pages together years ago, they did not know that one day they would be scanned and were not too careful in getting the pages lined up. We looked at Kodak, Canon and Bell & Howell Trüper and the Fujitsu came out on top".

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